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Snapping Scapula Syndrome

Do you hear clicking in your back when moving your arm up and down? You may have snapping scapula syndrome, the grating in the bones in the scapulothoracic joint.

What is the scapulothoracic joint?

While not a true anatomical joint, the scapulothoracic joint is the connection between the scapula and rib cage and functions to smoothly integrate the scapula’s movements with the arm movements. The scapula and rib cage are separated by the subscapularis muscle which aids in internal rotation of the arm, and the serratus anterior which aids in protraction of the scapula. The scapulothoracic joint is stabilized by the synchronized tensions of the trapezius, the serratus anterior muscle, levator scapulae, and rhomboid muscles. With such a complex structure, dysfunctions of the joint can occur when the supporting muscles dysfunction in any way.

What is snapping scapula syndrome?

Snapping scapula syndrome is a condition in which the tissues of the scapula thicken from excessive rubbing between the scapula and rib cage. This can be caused by repetitive overhead movements, like in sports like baseball and swimming. In other cases, the subscapularis and serratus anterior have shrunk from weakness or inactivity leading to less separation of the bones and causing grinding during movements. Misalignment of the scapulothoracic joint can also cause a bumpy ridge that causes grinding or snapping during protraction of the scapula. Regardless of the causes, the excessive grinding may cause a bursa to form and inflammation of this bursa can lead to pain and tenderness in the area.

Treatment of this condition involves reducing inflammation of the bursa through anti-inflammatory drugs to prevent further pain in the area. In addition, strengthening the subscapularis and serratus anterior can increase the space between the scapula and rib cage to prevent further grinding of bones.

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